Bonesetting, Chiropractic, and Cultism

Chapter 4: The Scope and
Requirements of Chiropractic

With five million people in the United States ill on any given day,
70 million in the course of a year, and over a million physicians, nurses,
and others caring for the sick . . . it is not necessary to argue for public
welfare as a major sector of "general welfare." Here again, silence
of the federal constitution throws responsibility primarily upon states
and localities [1].

It should be remembered, in the course of our discussion, that there
is no argument about the value of manipulation, as indicated, in selected
cases. The stand of many chiropractors, however, is that most of the diseases
afflicting mankind can be treated by manipulation of the spine. In comparing
the practice of a qualified osteopath, who practices both chemotherapy and
manipulation, with the practice of the chiropractor, we note what seems,
in observing, to be the obvious failure of manipulation to cure those conditions
for which the osteopath now administers modern medical therapy. Possibly
the higher standards of the osteopath have allowed him to abandon, to a
great degree, the basic principle that vertebral misalignment is the cause
of most disease.

The chiropractor does not claim to be just a specialist with a limited
practice; he is a competitor of the general physician. The chiropractor
is limited only in his methods of treatment, not in the type of cases he
may treat. The theory of his practice does not place limitations upon the
scope of his practice, The request of the chiropractor that he be extended
a "limited license" and still be granted the right to treat the
broad scope of disease seems, considering the standards governing medical
practice, to be quite unreasonable. In New York, for example, where chiropractors
have not yet been successful in obtaining licensure, Dr. Philip Allen, then
president of the New York Medical Society, stated in a newspaper editorial
entitled "The Doctor's Case Against Chiropractic":

The public through the State Board of Medical Licensure, has ever been firm
in its belief that no physician should be licensed on a limited basis to
treat some special branch of disease. instead the state rightly demands
that all persons licensed in medicine must have the finest and most difficult
education in all the basic sciences, plus education in both scientific and
clinical medicine. Physicians may specialize, as they do in later years,
but no physician ever received his license because he was a specialist first.
. . . The chiropractors seek to break this pattern by having the state license
them to treat only the human spine and on the basis of unproved methods
and concepts of disease which would have been laughed at by healers of the
17th.century. . . . They want to replace doctors and not work under them
[2].

Dr. C. W. Weiant, a chiropractic educator of the Chiropractic Institute
of New York, stated, in part, in reply to Dr. Allen's editorial:

Chiropractors should have a limited license. Such a license would define
the scope of their practice, protecting the public (as well as the physician)
from any illegal encroachment on the medical field.

In reviewing the manner of practice of the chiropractor, and the laws
enforced by the chiropractors themselves in states where they have their
own examining boards, one would have to assume that Dr. Weiant meant, by
his expression, "illegal encroachment on the medical field," that
the licensed chiropractor would not employ medical methods of treating disease,
for few, if any, state laws stipulate what conditions the chiropractor may
treat but only how he may treat them. (In four or five states, however,
the chiropractor is not allowed to treat contagious and infectious diseases.)

The chiropractors' efforts to treat disease by limited and nonmedical
methods form the basis of most of the argument against chiropractic. This
is apparently why New York has refused to license them-a refusal based on
a double-edged argument that the chiropractor, promulgating an essentially
false theory, does not receive sufficient training to treat human disease
regardless of how he might attempt to do it. To grant chiropractors a license
to treat disease, so that they may not encroach upon medical methods of
treatment, does not, of course, validate the basis of their treatment. Considering
the information given in the foregoing chapters, the treatment of joint
conditions by manipulation has always been a legitimate part of medical
practice. If chiropractors were strictly prevented from "encroaching
upon the medical field," it seems that they could very well be confined
to the treatment of disease by manipulation of the joints only (as provided
for in the chiropractic theory), without the use of any other form of therapy
and without the right to treat joint conditions Per se. Many of today's
chiropractors, however, in assuming that their limited method of treatment
is sufficient in the care of most disease, argue for their licensure on
that basis; they simply maintain that their practice is not the practice
of medicine and that medical practice laws and medical organizations have
no jurisdiction over their method of healing. Thus, on the basis of their
existence in numbers, chiropractors are licensed as competitors of the medical
physician, even though they are restricted by law and by creed to a limited
method of healing. Under the public's right to free choice of a doctor,
there often seems to be no alternative but to license services patronized
by substantial portions of the public, changing the law as the practice
changes, or repealing the law as the practice dies.

It is difficult to say whether a practice that is thought to be cultism
should be restricted by law to the fundamental tenets of that cult, or whether
that cult should be allowed to incorporate methods from other fields of
healing in order to stimulate progress toward higher standards. One argument
against allowing cults to incorporate legitimate medical methods of treatment
is based upon the fact that the development of a secondary Class C medical
practice would necessarily dilute the high quality of modern medical care-making
it difficult for the public to distinguish between low-grade and high-grade
medical practice.

For many impatient individuals who aspire to be "physicians,"
however, there probably never has been or never will be an easier way of
getting around difficult medical standards in applying for a license to
treat human disease than through the chiropractic theory. In addition, the
bloodless, drugless, and often attractive method of chiropractic sometimes
provides an alternate course for those squeamish individuals who may have
personal objections to medical treatment methods -- regardless of what is
or is not the correct method of treatment. Since chiropractors will not
or cannot qualify according to medical standards in the treatment of disease,
licensing bodies are forced to allow separate professional examinations
in order to permit chiropractic physicians to treat many of the same diseases
the medical physician would treat by different means.

A practitioner who wishes to employ manipulation could ideally do so
as a physical medicine specialist. Those who do not want the responsibility
of a physician and who still desire to work in the field of manipulation
could find excellent opportunity in the field of physical therapy. Many
chiropractors, however, whose training is little more extensive than that
of a physical therapist, assume the responsibilities of a general physician
while working in competition with medical practice and all of its specialties.
For these chiropractors to argue that they do not need a knowledge of the
use of drugs and surgery in order to conduct their practice is to say that
they will ignore or will not be aware of the correct method of treating
disease in many cases, and that they will simply apply the chiropractic
adjustment to a progressive illness that could possibly be better treated
by another method. The very fact that a chiropractor would apply for a license
to treat human disease in a general practice, without a knowledge of medical
treatment, and with the intention of treating all such diseases chiropractically,
seems to label him the cultist he is accused of being.

When legislative bodies are forced to license the practice of chiropractic
(which defines itself as a method of treating disease by adjusting the spinal
column), they have no alternative but to make special, provisions for chiropractors
and then restrict them to the practice of chiropractic as taught in chiropractic
schools. This, at least, prevents the chiropractor from encroaching upon
methods of treatment in which he has had little or no training. When he
begins to add methods of treatment outside simple adjustment of the spinal
column, the chiropractor begins to get close to the practice of medicine
as defined by law, and thus becomes more subject to licensure by medical
standards. This fact has provided many headaches for those in chiropractic
who want to elevate their profession above the "one cause, one cure"
level. In this respect, the low standards of chiropractic practice maintain
themselves to a great degree. When the standards of chiropractors do begin
to approach those of the practice of medicine (with chiropractic in general
competition with medical practice), I would imagine that qualified students
would rather undertake the practice of medicine than to suffer the stigma
and the limitations of chiropractic regardless of whether chiropractic remained
pure chiropractic or whether it adopted medical methods of treatment.

In spite of the fact that medical science does not recognize the chiropractor's
treatment for disease, chiropractors have been successful in obtaining a
license to treat disease in most states. In addition to legal recognition
in 46 of the 50 states, chiropractic is also recognized in the District
of Columbia, Mexico, Switzerland, Puerto Rico, Australia, and parts of Canada.
Outside these countries and the United States, however, legal recognition
is nil.

Minimum educational requirements for the chiropractic degree, as recommended
by the National Chiropractic Association, consist of four years of nine
months each with a total of 4,000 or more class hours. The National Council
on Education of the N.C.A. also recommends that chiropractic boards of each
state enact laws requiring two years of preprofessional study or "additional
college credits" as a licensing requirement for the practice of chiropractic
in each state. It seems, however, that the great majority of chiropractors
do not want a law designating two years of undergraduate college work as
a prerequisite for chiropractic education.

As of January 25, 1962, educational requirements for licensure, as compiled
by the National Chiropractic Association, showed that 25 states (and the
District of Columbia and Puerto Rico) required preliminary education varying
from "college credits" to two years of college preceding three
to four years of chiropractic training. In 30 states and the District of
Columbia, basic science examination or a combination of both medical and
chiropractic practitioners on the examining board play a part in the licensing
of chiropractors.

(In Alabama before 1959 the examining board was strictly medical. A chiropractor
who could pass the medical requirements could be licensed, although his
practice would be restricted to the practice of chiropractic. By 1953, a
total of two chiropractors had passed the medical examination and were licensed.
Only one of these was still licensed as of April, 1959, although there were
three hundred chiropractors practicing illegally throughout the State! As
of January, 1960, however, for the first time since 1923, provisions were
made for the licensure of chiropractors in Alabama by special examination.
Under the supervision of a healing arts board, governing the licensure of
both the medical profession and the chiropractic profession, chiropractors
are examined by a basic science board and then by their professional board.)

About 22 states and the District of Columbia have basic science boards;
five have mixed boards (combination of both medical and chiropractic examiners);
three states have a mixed board combined with basic science examination.
Sixteen states (and Puerto Rico) license chiropractors solely through chiropractic
examining boards. In four states -- Louisiana' Massachusetts, Mississippi,
and New York -- chiropractic is either not prescribed or not regulated.

According to a recent report by a representative of the National Chiropractic
Association, 28 states now have laws requiring preprofessional. college
credits for licensure as a chiropractor; this figure apparently includes
those states that have laws becoming effective at a later date.

Thus, with about 27 jurisdictions presently requiring preprofessional
college training for chiropractic licensure, and a few others scheduled
to enforce such requirements, only Western States College of Chiropractic
requires that applicants have two years of college prior to undertaking
chiropractic studies. This would seem to indicate that, by far, the majority
of chiropractic students are scarcely above high school level.

Even though fewer than half the states (21 and the District of Columbia)
presently have laws requiring that chiropractic licensees have two full
years of preprofessional college training, the enrollment in chiropractic
colleges has been reduced considerably by these requirements, and the number
of chiropractors in those states having such requirements has diminished
drastically. As noted in 1959 in the second eition of B.J. Palmer's book
Shall Chiropractic Survive!:

The Lincoln Chiropractic College Bulletin for March, 1958, after mentioning
the enactment of a two year preprofessional requirement in many states,
informed us, "These requirements for licensure have created an economic
problem for all chiropractic colleges, and the Lincoln College is no exception."

The state of West Virginia was one of the earliest (if not the first)
states to enact a two year preprofessional requirement for chiropractors.
We have been told that West Virginia once had between 80 and 90 chiropractors.
The I.C.A. Review for July, 1958, stated, West Virginia, with a population
of over 2,000,000 has fewer than 30 chiropractors in active practice [3].

As a general rule, those states requiring two years of preprofessional
training, basic science or medical board examination, show decreasing numbers
of chiropractors, while those states licensing chiropractors through chiropractic
examining boards show numbers somewhat constant or, in some cases, decreasing.
The number of licensed chiropractors in each state varies considerably,
depending largely upon the nature of the examination and the requirements
for licensure. The location of the state and the legal definition of chiropractic
may have much to do with the number of licensed chiropractors in a particular
state. In Florida, for example, an especially attractive state requiring
basic science examination, the legal definition of chiropractic permits
the chiropractor to enjoy a rather broad field of practice. As a result,
large numbers of chiropractors may take the Florida examination in preference
to many other states requiring only a chiropractic examination. The overall
picture, however, seems to show a definite tendency toward a continued decrease
in the number of chiropractors in most states.

In considering the small number of chiropractors in those states presently
requiring two years of preprofessional training, we probably get a fair
idea of the ultimate course of the "second largest healing profession"
(chiropractic); for it seems very likely that, as long as the chiropractor
continues to treat the entire body in a general practice in competition
with the medical physician, it will not be too long before every state will
require uniform standards for those who treat the same diseases. Whether
or not the chiropractic profession survives such requirements will probably
depend upon the changes made in its method (and its standards) in time to
come.

Evidence of the fact that the requirement of two years of preprofessional
training is a factor discouraging the enrollment of chiropractic students
is well exemplified in the course of events following the enforcement of
such requirements at the Los Angeles College of Chiropractic in 1952. From
522 students enrolled at that school in 1950, for example, the number dropped
to 93 in 1955; an 80% reduction of the student body in only three years.
When the school rescinded this self-imposed rule (requiring two full years
of preprofessional study) in 1955, the enrollment increased to 224 the following
year (1956).

It is interesting to note that there are at least four chiropractic colleges
in California -- one approved by the National Chiropractic Association,
one approved by the International Chiropractic Association, and two others
not approved by either of these organizations. The graduates of all four,
however, are permitted to take the California examination for licensure.
At one time or another, about 39 chiropractic schools have conducted classes
in California. Out of the hundreds of chiropractic schools that have "opened
shop" in the United States since the beginning of chiropractic, there
are probably about 20 still in operation; eight are approved by the National
Chiropractic Association and seven by the International Chiropractic Association.
A 1959 N.C.A. journal stated: "The NCA membership . . . represents
doctors of chiropractic who have graduated from 72 different educational
institutions." [4] The 1960-61 Membership Roster of the International
Chiropractic Association names 91 different chiropractic colleges from which
its members are drawn.

Interestingly enough, a good many of the unapproved chiropractic schools
(not approved by the N.C.A. or the I.C.A.) are in New York where the practice
of chiropractic is illegal but where, nevertheless, many chiropractors practice.
In 1952, for example, there were 2,676 chiropractors in New York! Today
there are more than 3,000!

Preprofessional Training of Chiropractic and Medical Students

With the exception of one chiropractic college that has pre-college entrance
requirements, it seems that the chiropractic colleges are thoroughly against
entrance requirements above high school education, since, as we have noted,
there is already a shortage of students in chiropractic colleges and a resulting
decline in the number of chiropractors in most states. Chiropractic colleges
feel that further elevation of educational requirements for the study and
practice of chiropractic would only further decrease the number of chiropractic
students and practitioners. Although this may be true, it is also true that
such low educational standards do not permit accreditation by the United
States Office of Education. As a result, unapproved chiropractic colleges
fail to attract the attention of thousands of students enrolled in general
undergraduate training in hundreds of accredited colleges.

The situation of the chiropractic schools in being unsought by increasing
numbers of college applicants and college graduates is revealingly significant,
and is discussed in other parts of this book. Many chiropractors who are
against enacting a two-year pre-college requirement for chiropractic education
and licensure maintain that this length of time is not necessary to learn
the practice of chiropractic. They further insist that six years of training
required for chiropractic education is too closely approaching the requirements
for medical education, which they feel are quite unreasonable inasmuch as
they "have caused a shortage of medical doctors."

Actually, the shortage of medical doctors seems to be due to a lack of
the facilities needed to train the number of physicians required to fill
public need and demand. While the overall number of applicants for medical
education may have decreased because of higher educational requirements
and the passing of recent war years, the medical schools have never had
a shortage of students in their classes. In addition, the number of students
applying for medical education is expected to rise considerably in the near
future, in spite of the fact that it is becoming increasingly difficult
to get into a medical school without first having four years of premedical
training. Thus, while there may be a shortage of medical physicians in meeting
public need, the chiropractic profession seems to suffer from lack of students
because of public apathy toward chiropractic in general -- regardless of
the fact that any high school graduate can easily enroll in a chiropractic
college. A 1962 National College of Chiropractic solicitation advised prospective
students, for example:

What must I do, you ask, to get started in this work? Can I do as well
as your other graduates? Yes, you can! A 36 months' course (including externship)
at the National College of Chiropractic, a foremost and fully accredited
college of chiropractic, adequately prepares you.

Medical schools, on the other hand, select students from those in the
"upper-half" grade bracket and turn away the rest. About two-thirds
of the first-year medical classes have a grade average of "B,"
while approximately one-fifth have a grade average of "A." The
May 9, 1958, issue of U.S. News and World Report, commenting on the
shortage of medical physicians, stated:

Only half of the applicants for admission to medical schools were accepted
in 1956, the last year for which figures are available. The colleges did
not have room for more [5].

In determining the scale of selection for medical students, applicants
for medical training are given national Medical College Admission Tests.
Students in the upper half are accepted and those in the lower half are
rejected. Medical educators say that medical courses are too difficult for
"all but the upper-group students."
Due to the responsibility and the difficulty of learning and conducting
a qualified medical practice, it shall always be necessary to select students
from the top half of all those who apply for medical training. The larger
the number of students who apply for medical education, the higher the quality
of the selected students. While it seems unfortunate that a student might
spend four years in premedical education only to be rejected by the medical
colleges, this is sometimes necessary if the nation's medical services are
to be maintained on a Class A level. There are many other attractive fields
into which a rejected premedical student may extend his training. Perhaps
the development of more schools and hospitals for training large numbers
of physicians would increase the number of top-rank students applying for
medical education, since they would be more reasonably assured of being
accepted. (There are more than 2,000 Americans studying medicine in foreign
schools because the schools in this country are too full to accept them.)
Thus, the number of physicians per population could be increased (or at
least keep pace with population increases) and still permit the quality-ratio
of student selection to be maintained.

Almost without exception, the student who gains entrance to a recognized
medical school has already completed four years of college training. The
school may require this in spite of the fact that statutory law might require
that a medical student have only two years of pre-medical training for licensure
in a particular state. A graduate physician will have completed 10 to 12
years of training before he is released to private practice.

Four years, or even six years of training for chiropractic licensure,
is considerably less than the time required for medical education. The failure
of chiropractic schools to fill their classes directly from high school,
and the retrogression resulting from statutory laws requiring two years
of preprofessional training, seems to reflect considerably upon what chiropractic
is thought to be -- or not known to be -- by those both qualified and unqualified.
Apparently, of the thousands of students refused admission to a medical
school because of insufficient grades or lack of openings, even though they
have completed four full years of premedical training, few consider applying
for admission to a chiropractic college. A considerable number of them do,
however, apply for admission to an osteopathic school.

In any event, there is not a shortage of prospective students who have
had some academic training -- and they are increasing in number. In fact,
due to steadily increasing numbers of students applying for college training,
it has been estimated that the number of students applying for medical training
will rise from 15,000 today to about 33,000 by 1965. In order for the present
ratio of physicians to population to be maintained, however, (132 physicians
for each 100,000 persons) at least 22 additional medical schools will have
to be in operation by 1975 -- if the present population trend continues.

The Doctor Shortage

In discussing the possible shortage of medical physicians, there is one
alarming point to be considered: that is the possibility of second-rate
doctors filling the needs of those not cared for by Class A physicians.
It might be relatively easy, for example, for any licensed "drugless
healer" to progressively step over into the realm of medical practice,
thus offering substandard medical care. If a shortage of medical physicians
should become more acute, without sufficient facilities for training more
physicians, Dr. Ward Darley, of the Association of American Medical Colleges,
warns that "The medical schools would be under great pressure to admit
more students than they could properly teach. They might be pushed into
taking students who are not qualified to study medicine." Dr. Darley
also stated that, "The licensing boards . . . would be under pressure
to lower their standards. There are thousands of graduates of foreign schools
who are not considered sufficiently qualified at present to be given a license
to practice. If conditions became worse," he continued, "the bars
might be lowered enough to let them in." The U.S. News & World
Report commented, following Dr. Darley's statement: "In the future,
some medical leaders believe, the public may not only find it more difficult
to get a doctor when one is needed, but the doctor who answers the call
may not be as competent as those now available." [5]

Although chiropractic, with its stigma of cultism, its short-term education,
and its limited method of treating "most human disease," seems
to be having a difficult time surviving, in spite of what is happening in
the medical field, there is, of course, the possibility that it might sufficiently
alter its definition to permit progressive encroachment upon medical practice
as demands for more general medical care mount up. Barring any change in
the fundamental doctrine of chiropractic, however, two or more years of
preprofessional training would add little to the competency of one who believes
that most disease is the result of one or more subluxated vertebrae, Chiropractors
and other drugless or sectarian practitioners, adopting Class C medical
methods in order to survive, might be perpetuated by the patronization of
persons who are not able to distinguish one type of doctor from another.

It is interesting to note that the Utah naturopaths, before a hearing by
the Welfare and Education Standing Committee in Utah, recently, sought the
right to "administer drugs, perform minor surgery, and practice obstetrics"
on the grounds that there were not enough physicians in rural areas to care
for the sick. Any possible shortage of qualified physicians in the future
might well encourage the existence of "second-rate" doctors. As
yet, however, a supposed shortage of medical doctors does not seem to have
encouraged the existence of the chiropractor to any great extent, although
many chiropractors, in some areas, are filling the capacity of "family
physician" by using "drugless methods." Chiropractors are
often encouraged, by leaders in their profession, to step in as "general
practitioners" when medical specialization fails to provide the services
of a family doctor. In the October 1960 issue of Harper's magazine, Dr.
David A. Rutstein commented: "For lack of a family doctor, many people
are taking their problems to such advisers as Christian Science practitioners,
marriage counselors, chiropractors, or naturopaths." [6]

It seems, however, that many chiropractic colleges do not look forward
to attracting a sufficient number of students from a college level, for
in a chiropractic publication we find this statement:

What about recruitment of students from colleges or junior colleges?
It is not likely that this will produce any significant increase in the
number of Chiropractic students in view of the intense competition for
scientists and engineers, to say nothing of keen competition in all other
healing arts. With prejudice against Chiropractic which exists in many
colleges, it is not expected that college experience will lend any encouragement
to one's plans to be a chiropractor. Unless, therefore, the college student
has a strong conviction about Chiropractic to begin with, the chances are
he will end up in some trade or profession which offers more hope of public
acceptance with less personal sacrifice. Even if he has a predisposition
toward Chiropractic, his interest is likely to become diluted after two
years of college. . . . What has been the effect of the two year requirement
in those states where it has been in existence for a number of years .
. . there has been no increase in the size of the profession since the
early 1920's. If requirements are further increased, all indications point
to a dying profession [7].

Thus, it seems that chiropractic is not much more attractive to the high
school graduate than to the college student. In any event, it might be considered
somewhat misleading to lure an uninformed high school graduate directly
into the profession of chiropractic and have him avoid the proper undergraduate
training because of the "prejudice against chiropractic which exists
in many colleges." Certainly the prospective student should be well-grounded
and informed of all the advantages, disadvantages, and conditions under
which he may conduct a chosen profession. The ability of a student to make
a proper choice depends a great deal upon proper undergraduate training.
It should be considered quite improper for a chiropractic college to guide
a prospective student away from the fundamental education so necessary and
standard in America's program of professional education.

Since chiropractic colleges have no reciprocity with other accredited
colleges or organizations, a graduate of a chiropractice college who might
decide to change his professional career will find himself in the category
of a high school graduate when he places his application for further college
training or for college-dependent employment. A graduate of any accredited
college, however, may transfer his credits from one college to another for
extension of his training into another field if he should so decide. This
is one reason why most accredited professional practices require certain
fundamental undergraduate training, and another reason why every student
who wishes to be a professional man should first attend an accredited liberal
arts college.

Two years of undergraduate study should not, of course, be considered
too rigid a requirement for entrance into a chiropractic college (when compared
with the more rigid requirements of medical schools), especially for those
chiropractors who would consider themselves on a level with the medical
practitioner. Yet, preprofessional training for chiropractic trainees and
licensees is a subject of great controversy among chiropractic educators
and leaders.
Actually, two or more years of academic college training is becoming quite
a common possession; a fact that, when considered, reflects unfavorably
upon the status of the struggling chiropractic colleges. If the present
trend of education continues, for example, it is likely that the number
of bachelor's degrees awarded annually will be more than double the current
figure by the late 1960's. Projections prepared by the U. S. Office of Education
in March, 1956, indicated an increase from 311,000 bachelor's degrees granted
in 1956 to 437,000 in 1960; to 567,000 in 1956; and to 766,000 in 1970.
In addition, there are increasing numbers of students taking graduate training
for master's and doctorate degrees. The number of master's degrees is expected
to rise from about 58,000 awarded in 1955 to more than 100,000 in 1965.
The number of doctorate degrees awarded (8,800 in 1955) may also double
in the same ten-year period. The Office of Education of the United States
has suggested that by 1970 the number of master's degrees conferred may
exceed 160,000 and doctorate degrees may approximate 20,000 [8].

In the health professions offering degrees (according to the U. S. Office
of Education), 25,750 degrees were conferred in the year of 1957-58. The
degrees were distributed, in part, as follows:

Chiropody or Podiatry

120

Dentistry

3,065

Medicine

6,861

Occupational Therapy

416

Optometry

337

Osteopathy

443

Pharmacy

3,963

Physical Therapy

473

Veterinary Medicine

845

The remainder of the degrees were distributed among other health professions,
not including the profession of chiropractic. No mention was made of the
chiropractic schools [9]. When we recall the fact that there are about 800
chiropractors graduated each year, this figure seems to compare favorably
with many of the figures given above. The chiropractor, however, as a competitor
of the medical physician, expresses consternation over static chiropractic
figures as compared with the growing figures of medical practice. In any
event, the great majority of chiropractic applicants have had no pre-college
training,, and their number decreases in direct proportion to the enactment
of such requirements for licensure in the various states. Since it seems
likely that requirements for preprofessional training in the healing arts
will soon become law in most states, many chiropractic colleges will probably
have to amalgamate their classes and facilities in order to survive. The
difficulty besetting chiropractic would then be found in competing with
other health professions having nearly the same requirements. This might
prove to be disastrous for the chiropractic profession if its practice and
theories remain unapproved by the nation's health and educational institutions.
The only sensible alternative would seem to lie in a specialization in cooperation
with medical practice, although it would mean a reduction in the number
of schools and graduates, even after chiropractic had achieved better recognition.
The magnitude of the chiropractic problem will become more apparent as the
reader covers the material of this book.

Medical Education

In 1948, approximately 25,000 students applied for training in medical
colleges. Of these, approximately 7,000 were accepted and the other 18,000
rejected. There were 3.6 applicants for each freshman vacancy. In 1956-57,
15,918 students applied for entrance into medical schools. Of these, approximately
7,824 were selected for medical training, 83% of whom had a "B"
grade average or better. Seventy-three percent had degrees. In 1957-58,
15,791 applied for training in medical colleges and 8,030 were admitted.
The ratio of applicants to places in the freshman class was 1.9 to 1, as
it was in the previous year [10].

Today, because of the expense of medical education and the difficulty
of gaining entrance into a medical college that has limited training facilities,
the applicant ratio for each vacancy in medical schools has dropped from
3.6 in 1948 to about 1.9. This means that about half of those who apply
for medical training will be admitted. It might also mean that, of the 7,000
students selected today, compared with the 7,000 selected in 1948, the student
quality might be slightly less since the field of selection has been cut
somewhat. The year of 1948, however, was a postwar period with large numbers
of veterans applying for education under the GI Bill of Rights. Requirements
for admission to the medical colleges were necessarily more demanding at
that time, considering the number of applicants, than they would be with
a lesser number of applicants. Today, however, larger numbers of medical
students have four years of premedical training, which means that those
accepted are better prepared to undertake the complicated study of medical
practice.

Although there has been a steady increase in the number of students enrolled
in medical schools (in 1930-31 there were 21,982 medical students enrolled
in 76 schools; in 1944 there were 24,666 enrolled in 77 schools; in 1960-61
there were 30,288 enrolled in 86 schools), the ratio of physicians to population
has been about the same over the past 50 years or so. There is little question,
however, considering the rapid rate of population growth and the present
number of medical schools, that there might well be a shortage of physicians
in the near future if more medical schools are not constructed. Perhaps
additional medical schools, with more Federal assistance to cut the cost
of medical education, would encourage a larger number of applicants for
medical training and the acceptance of a greater number of students.

Primarily, it seems, any present shortage of physicians is probably due
to a lack of the necessary facilities needed to train larger numbers of
physicians. As we have noted elsewhere, there seems to be no question that
there will be increasing numbers of students applying for medical training
in the future, since enrollments in colleges around the country are increasing
at a rapid rate.

In demonstrating the need and demand for medical physicians, I merely
wish to expose the contrasting unpopularity of the chiropractor as a physician.
In any event, the medical schools are full, and to refer to a shortage of
medical doctors is not to compare the situation of the chiropractic colleges
(that cannot get enough students from the high school level) with the inability
of the medical schools to train an adequate number of physicians. The struggling
chiropractic physician seems to be waning in popularity and numbers, in
spite of the fact that there seems to be a shortage of doctors.

Today, the nation's 86 medical schools graduate more than 7,000 physicians
a year, and, in order to maintain the existing physician/ population ratio,
at least 12 new medical schools were being planned as of November, 1962.

All of the medical schools require at least three years of college training
as an entrance requirement, and about nine schools require four years of
college work. About 73% of all medical school applicants have academic degrees,
however, and it is becoming increasingly difficult to get into medical school
without four years of undergraduate work. In 1955-56, only 69% of the freshman
classes had college degrees, but in 1956-57 approximately 73% had degrees
and 77.5% had four years of college. By 1958, the percent of the entering
class with four years of college had increased to 79.2. Each year, more
schools enroll freshman classes of which more than 90% have degrees. In
addition to a trend toward greater college preparation before entering medical
school, plans are now being made to lengthen the study required for the
general practice of medicine [10].

In view of the tendency of medical practice to lengthen preprofessional
requirements and hospital training, preceding and following four years of
medical school, it is difficult to understand how a chiropractor with only
four years of training beyond high school could attempt, with any conviction,
to compete with the medical physician in the treatment of disease. While
the chiropractor seems to be reluctant to spend any additional time in training,
the medical student, on the other hand, seems willing and even desirous
of extending his education. In questionnaires received from 3,269 interns
and residents, for example, all but about 105 expressed desire to seek a
specialty board certification (which would entail additional study). Approximately
two-thirds wanted additional training in research regardless of future specialization
[10]

In 1923, only about 11% of the nation's 146,000 physicians were full-time
specialists. As of May 22, 1959, about 44% of 228,295 physicians were specializing
(21,877 part-time specialists and 77,655 full-time specialists) . Since
many of the specialty boards are of recent origin, only about 56,910 had
specialty board certifications. By June of 1962, there were more than 90,000
certified specialists in the United States . (Although there are about 32
specialties in medical practice, there are only 19 specialty boards approved
by the Council of Education of the A.M.A.)

Probably a longer preparation for the study of medicine has enlarged
the medical student's capacity to understand and absorb the more detailed
and extensive medical sciences. In addition, years of study in the fundamental
sciences and in medical practice per se no doubt provides the student with
an understanding sufficient to stimulate his interest in research and new
thought. It is interesting to note that, in 1912, two years after Abraham
Flexner's report revealed the existence of low standards in many medical
schools, Henry S. Pritchett wrote:

The medical curriculum . . . has reached the limits of its capacity:
it can contain no more. . . . It is clear that educationally we have come
almost to an impasse, that the load not only cannot be increased, but for
the sake of good teaching it must be simplified. The medical student .
. . must have a timely opportunity to ground himself in fundamental studies,
and to learn how to think, how to observe, how to apply. Every pedagogical
consideration, therefore, points to the conclusion that the elementary
underlying sciences must be learned by the student of medicine . . . before
he enrolls himself in the professional school [10]

As time passed, however, the inclusion of more basic science study in
premedical training in turn permitted enlargement and lengthening of the
study of the ever-expanding scope of medical practice. A student not thoroughly
grounded in basic studies before embarking upon the study of medical practice
could not hope to absorb or understand the medical sciences. In the chiropractic
colleges, where high school graduates and those with two years of undesignated
college training undertake studies to become chiropractic physicians, the
student can be expected to absorb very little outside the basic sciences,
since such studies are undertaken at the same time therapeutic measures
are studied. A well-grounded medical student might have less difficulty
in complicated medical studies than a chiropractic student would have in
the basic sciences. In addition, it would seem that the wider and more specific
responsibilities found in medical practice would spur the medical student
into more active participation and study of the medical skills, while the
chiropractor, who finds an answer to his questions and his needs in the
chiropractic adjustment, might be quite content to rationalize the use of
a single treatment method.

In acquiring knowledge, especially for the duties of a physician, there
is a certain point below which a rational understanding is quite impossible
and any further study quite inconceivable. (This may be just another way
of saying that "a little of knowledge is a dangerous thing.")
As the medical student, enlightened by years of fundamental study, expresses
a desire to extend the course of his technical studies, the chiropractor,
generally confused in his "accelerated" course to become a physician,
refuses to lengthen his course of study, since the chiropractic curriculum
seems to have "reached the limits of its capacity." In addition,
the chiropractic theory nullifies the need for extensive studies and the
use of various medical skills, and the simplicity of the chiropractic treatment
makes up for any lack of understanding of the medical sciences. In the acquisition
of knowledge, there is probably a certain point above which the chiropractic
student would tend to abandon the spinal adjustment as a treatment for most
disease.

It is significant to note that, in medicine, as in other accredited branches
of the healing arts, the requirements of its schools considerably exceed
those put down by the state law. The majority of the chiropractic schools,
however, are still below the standards set by a considerable number of states,
and the student is compelled to meet these requirements of his own choice.
For example, a student who has two years of college training may attend
a chiropractic college that does not have preprofessional (college) entrance
requirements and still apply for licensure in a state that requires six
years of training. As a general rule, chiropractic standards in a particular
state seem to be maintained only at the level of the law, while the chiropractic
schools might maintain standards equal to or less than those demanded by
law. In most other fields of healing the situation is quite the reverse.
The average medical graduate, for example, will have spent about ten years
in training before he becomes a full-fledged physician, regardless of the
fact that statutory law in a state in which he seeks his license might not
require a period of training that long. If he studies a specialty lie will
have to study an additional two to five years. It is possible to spend a
total of 14 years studying for a surgical specialty. A specialty in general
surgery requires four additional years of training following medical school,
for example, while five years is required for a specialty in neurosurgery.
Yet a state law might stipulate that a physician have only six years of
education for licensure.

Medical Care and the Population

The question of whether or not there is a shortage of physicians is debatable
in some circles of thought. Some contend that the better-trained physician
of today can take care of a larger number of patients due to a modernization
of technics, facilities, hospitals, and so forth, and that the population
growth has not exceeded the capabilities of the modern physician to care
for it. However, the scope and knowledge of medical science has so widely
expanded in the past 50 years that some physicians have been forced to limit
their practice to certain specialties in order to effectively meet their
responsibilities, This, in itself, has created a need for a larger number
of physicians, both specialized and general.

The population has increased tremendously in the last 50 years. In the
United States alone, the birth rate and death rate are such that, if continued,
the population will double its number in the next 40 years. This fast increasing
count is due largely to the fact that medical science has drastically cut
the death rate while, at the same time, the population has not exercised
reasonable control over its birth rate in order to balance the scale. Between
1910 and 1956, for example, infant mortality decreased about 78%, while
the death rate in children of preschool age dropped 92%. The mortality rate
of children in other age groups decreased by 75%. In addition to the increase
in population count as a result of reduction of the child death rate, there
are increasingly larger numbers of adults over the age of 65. In the United
States, the percentage of the population over 65 years of age is about twice
that of 1900. In 1950, there were 12,269,537 persons over 65 years of age.
By 1960 this number had increased to 15,708,000. In addition to creating
a greater need for the medical specialty of geriatrics (study of old age
and its diseases) , increased numbers of older persons will create a greater
demand for general medical care. According to the National Health Education
Committee, the general death rate has declined about 11.3% since 1944, due,
in part, to the use of such drugs or antibiotics as penicillin, streptomycin,
and so forth, in the treatment of infectious diseases. This decline in death
rate represents a saving of almost two million lives. If an explosive population
count should lead to a shortage of physicians, the patient load of physicians
will be increased tremendously.

According to Health Statistics in the United States, July 1957 to June
1959, as compiled by the U. S. Public Health Service, the number of visits
to the physician averaged five per person per year. "A physician visit
was defined in the survey as a consultation with a physician, either in
person or by telephone, for examination, diagnosis, treatment, or advice.
. . . For the purposes of the survey 'physicians' were defined as doctors
of medicine and osteopathic physicians." Thus, in spite of the increasing
patient load being placed upon physicians, inferior qualifications of "chiropractic
physicians" bar them from recognition.

The Cost of Chiropractic and Medical Education

The quality of chiropractic education (in the study of human disease
and its treatment), as compared with medical education, is probably best
reflected in the cost of education per student in each college, The cost
of medical education has risen considerably over recent years, while the
cost of chiropractic education has risen only slightly. In a bulletin of
the Chiropractic Institute of New York, of 1953-55, for example, we note
that the charges are approximately the same, in that school, as those reported
by a committee from New Jersey in 1949. This was about $400 per year. During
that time, the cost of medical education at the Louisiana State University
of Medicine, per year, was approximately $2,500, and the cost of four years.
about $10,000. In 1958, the tuition-supported Chiropractic Institute of
New York charged $250 per term ($500 per year), while the cost of medical
education at the Louisiana State University School of Medicine had risen
to approximately $3800 per year. The actual tuition charged by state-supported
medical schools, however, is only a fraction of the actual cost of the student's
education, since such schools receive teaching grants and other forms of
aid to balance the books. The average cost (to a university) of educating
a medical student is about $12,000, yet the student's tuition for the course
may average only about $2,532, Other factors involved in the education of
the medical student, however, result in considerably more cost to the student
over the complete course of medical education and training. It has, been
estimated, for example, that medical education up to 12 years in length
(including the necessary preprofessional training and internship) would
cost the student or family about $15,000. The total cost of training a medical
specialist is about $67,000. Without outside aid, medical education would
obviously be too expensive for all but very few to undertake.

In addition to receiving teaching grants from federal and state sources,
medical schools also receive much outside help from private sources in conducting
education and research programs. From 1940 to 1957, the amount spent for
medical research alone increased from $45 million to $330 million. About
half of this went to medical schools and universities, and laboratories,
while the rest went to government research organizations and industry engaged
in medical research. The proportion of all medical research financed from
federal sources has risen from about 10% immediately before World War II
to about 50% in recent years. Of the total amount of medical research conducted
in medical universities, about two-thirds was financed by the government
(1957). The chiropractic colleges, on the other hand, receive no outside
grants or aid and must run the schools primarily on student tuition, support
from the profession, and returns from the schools' clinic activities.

The quality of chiropractic and medical education might also be revealed
by comparing the tuition in each school against income per student. The
Los Angeles College of Chiropractic, for example, primarily a tuition-supported
school, charged $438 a year for tuition in 1957, with an income per student
of only $709. Nearby public-owned UCLA Medical School, however, charged
only $178 per year for tuition, with an income per student of $13,942 [11].
The tuition in privately-owned medical schools would be considerably higher,
since their income per student may be less than that in public-owned schools.
According to the November 17, 1962, issue of the J.A.M.A., 87 medical schools
reported total expenditures of $436,053,795 in 1960-1961, an 82% increase
over 1956-57.

Chiropractic Education

"The curriculum of all the approved chiropractic schools has been
copied hour for hour from the American Medical Association's requirements
for medical schools," observed a medical author in his study of the
chiropractic profession [12]. In addition, the Director of Education of
the National Chiropractic Association stated: "Nothing in these subjects
should be withheld from the chiropractic student. There should be no difference
in the scope of the knowledge imparted. It is only in the application of
the knowledge that the education in chiropractic schools should differ from
that in the schools of other healing arts."

It is difficult to understand how the chiropractic student could study
the same basic sciences as the medical student and then restrict his treatment
to spinal adjustment. It would seem that a chiropractor would have to ignore
his studies in pathology, for example, to prescribe spinal adjustments for
an organic disease, or to assume that chiropractic "science" is
more correct than the present-day medical sciences. If chiropractors were
technicians applying their treatment under prescription, then a lengthy
education would not be necessary. As long as they are competitors of the
medical physician, however, their standards of education will necessarily
have to be as high as those of the physician in order to select and treat
diagnosed human disease -- a difficult thing to do requiring the best of
training -- regardless of the simplicity of the method of treatment.

For the most part, the chiropractic method of treatment is rather simple
and uncomplicated. If nerve interference were the cause of most disease,
then lengthy education would not be necessary in the field of diagnosis
and treatment-at least not for those who practiced chiropractic. As we have
noted, however, at least one chiropractic educator has admitted that the
scope of knowledge imparted to medical and chiropractic students should
be the same, although different in application. Assuming that there may
be different interpretations of the same science, it would then be necessary
to compare the teaching capacity of the two different schools of thought
in order to determine whether one was as pedagogically qualified as the
other.

An 1957 article in the New York State Journal of Medicine commented
on the condition of the chiropractic schools:

A tabulation of five of the eight approved colleges shows that of a
total listed faculty of 111, only three have the Ph.D. degree. Total faculty
members shown for the five colleges ranged from a high of 35 to a low of
nine.

The ratio of faculty to students in chiropractic colleges cannot be
determined readily. However, two catalogues reviewed gave current student
lists. From these it was determined that one college had a faculty of only
35 and a student list of 323. The other showed an even lower ratio; for
330 students it lists a faculty of only 20 [13].

A more recent tabulation of all eight chiropractic colleges approved
by the National Chiropractic Association revealed a total faculty number
of 165. About 37% of this number had academic degrees (as shown in catalogs).
Seven had Ph.D. degrees, six of whom did not have the D.C. degree. The total
number of faculty members in each college ranged from a low of nine to a
high of 38.

According to the Haynes-Stanford study of chiropractic in California,
about one-third of the school faculty members (in California chiropractic
schools) indicated that they had college degrees in addition to the chiropractic
degree. However, only 60% of those who claimed academic degrees were verified
when the registrars of the colleges and universities named were contacted
by Haynes-Stanford researchers.

Only 38% of those in teaching positions in chiropractic colleges stated
that they had some college training, and "many of those with prechiropractic
college training had majored in education, business, sociology, and other
fields not directly related to the healing arts." [11]

One college had a faculty of 15 for 198 students, and another a faculty
of 32 for 193 students (showing a decrease in faculty and student body since
1957). The Palmer School of Chiropractic, approved by the International
Chiropractic Association, claimed 32 instructors for 1,000 students. Tuition
in all eight of the schools approved by the National Chiropractic Association
averaged about $484 a year.

As a competitor of the medical physician, it would appear that ,he chiropractor
does indeed reflect his shortcomings in his roster of instruction.

Contrast, for example, the conditions found in any chiropractic school
with those found in any medical school where all faculty members have M.D.
or Ph.D. degrees, or both. Practically every medical student today has a
bachelor's degree, a degree that seems to be quite scarce among the faculty
members of most chiropractic colleges.

The University of Alabama Medical College, with an enrollment of approximately
300 students, has over 300 instructors, at least 100 of whom are full-time.

Emory University, of Atlanta, Georgia, has a student body of 285 in
the School of Medicine, with 122 full-time, 22 part-time, and 480 volunteer
members on its faculty.

The Northwestern University Medical School, of Chicago, Illinois, has
519 students with approximately 1,000 members on its faculty, the majority
of whom, of course, are part-time.

The University of Illinois College of Medicine, with an enrollment
of over 700 students, has a faculty of approximately 1200, 125 of whom
are full-time, 150 part-time, and the remainder nonsalaried members.

The Indiana University School of Medicine has an enrollment of 583
students (1958-59) with approximately 100 full-time staff members and 250
active volunteer members.

One should not, of course, be so naive as to assume that the high quality
of medical training depended upon larger and larger numbers of instructors.
Since the staffing pattern varies from medical school to medical school,
there may be varying number of instructors in the best of these schools;
in all of them, however, a ratio of faculty to students sufficient to teach
the difficult medical sciences is maintained above a certain level. In addition,
the number of full-time faculty members in a medical college is supplemented
by full-time members of hospital staffs (who instruct the student in hospital
and clinical procedures) .

Since chiropractic college catalogs do not usually state how many of
the listed faculty members are full-time instructors, it is difficult to
determine the student-teacher ratio on a full-time basis. In a study of
chiropractic schools in California, however, the Haynes-Stanford report
revealed that -- in the number of students for each full-time instructor
-- "the osteopathic school ratio was 4.3 times lower and the medical
school ratio 8.1 times lower than that of the chiropractic schools."
[11]

The Western States College of Chiropractic, of Portland, Oregon, approved
by the National Chiropractic Association ' is the only chiropractic college
presently requiring two years of college work as an entrance requirement.
Although its catalog states that "the two years of college constitutes
the minimum which is required," a letter from the Registrar said that
". . . we will waive this requirement if you intend to practice Chiropractic
in a state where this is not a legal requirement for licensure" (May
17, 1962). Of 22 members on its faculty, about eight had academic degrees;
none had Ph.D. degrees. In 1946, the Western States College offered D.C.,
N.D., B.T.A., and B.T.Sc. degrees with only 13 members on its faculty (see
Appendix, Degrees Issued in Chiropractic Colleges). The school includes
the instruction of physiotherapy in its regular curriculum, thus teaching
"mixed" chiropractic.

The Bulletin of the Los Angeles College of Chiropractic states that a
candidate "should present certified transcripts of records show ing
that he has completed, with a satisfactory record, two full academic years
of pre-college work." [14] A letter from the Registrar (December 26,
1962), however, stated that: "All that is necessary is a high school
education. We prefer that students have had college work, but it is not
mandatory." The Los Angeles College rescinded its pre-college requirements
in 1955. Its 1963-64 catalog listed 38 active instructors, 18 of whom had
academic degrees (three of these had Ph.D. degrees, but did not have D.C.
degrees). Approved by the National Chiropractic Association, the Los Angeles
school teaches "mixed" chiropractic.

The Level of a Profession

Unlike the practice of medicine, prospective chiropractic students are
not familiarized with the practice and the doctrine of chiropractic through
regular academic channels. In addition, there are no accredited educational,
medical, or public health organizations that recognize or recommend the
chiropractic colleges. There is little or nothing to be found in public
libraries that is favorable to the practice of chiropractic. Inquiry outside
the bounds of the chiropractic profession is likely to result in a negative
or unfavorable reply. The United States Commissioner of Education, for example,
of the United States Department of Health, Education, & Welfare, Office
of Education, does not recognize any chiropractic or naturopathic organization
or association whose job it is to accredit the chiropractic and naturopathic
schools. The Commissioner is required by Federal law to "publish a
list of nationally recognized accrediting agencies and associations which
he determines to be reliable authority as to the quality of training offered
by an educational institution. . . . Inclusion on the list of a nationally
recognized accrediting organization is generally accepted as the most significant
available indication of institutional quality."[16]

Of the healing arts, the accrediting agencies of anesthesia, chiropody,
dentistry (and dental hygiene), medicine (and medical technology), nursing
(and occupational therapy), optometry, osteopathy, pharmacy, physical therapy,
public health, veterinary medicine, and X-ray technology are included on
the commissioner's list, but the accrediting agencies of chiropractic and
naturopathic schools are not included. Recalling our discussion concerning
the reluctance of chiropractic schools and organizations to adopt requirements
for two years of preprofessional college training, and the fact that such
requirements seem to hinder the growth of the profession where they are
in effect, it seems that a difficult situation is presented insofar as approval
of the chiropractic schools is concerned -- especially since approval will
not be forthcoming until higher and more uniform educational standards are
adopted among the chiropractic colleges.

The more intelligent chiropractors have recognized the dire needs of
their profession, and, usually as individuals, recommend higher educational
standards. The Director of Education of the National Chiropractic Association,
for example, spoke out in 1941 for higher standards:

Parenthetically I might say that, if the statement is made anywhere
that this effort to elevate educational standards has for its ulterior
motive the destruction of chiropractic, that statement is false, without
foundation or logic. There is not a single school in this country -- "straight"
or "liberal" -- which could not adopt our standard without benefit
to their particular philosophy or brand of chiropractic.

Commenting on this statement, in 1953, Dr. C.E. Boyd, author of the booklet
The Cult of Chiropractic, said:

We can see that the more intelligent chiropractors, realizing the extremely
low standards, have been trying to raise the standards to some extent.
John J. Nugent, D.C., has even suggested that the State Boards raise their'
requirements to the standard of their "approved" schools. Assuming
Mr. Nugent's good faith, and also assuming that chiropractors were chosen
with an intellectual level average to other professions, and assuming further
that the basic sciences taught in the chiropractic schools were as good
as those taught in the medical schools, assuming all of these things which
are certainly not all true, the end result would still be, even according
to Mr. Nugent, a man who still believed that disease of the human body
could be treated by manipulation of the vertebral column, by the "chiropractic
thrust." [12]

Dr. Nugent's referral to "particular philosophies or brands of chiropractic"
in his plea for higher chiropractic educational standards probably demonstrates
as well as anything the difficulties besetting those who take the initiative
to raise the quality of practitioners who, according to the author above,
"still believe that disease of the human body can be treated by manipulation
of the vertebral column, by the 'chiropractic thrust.'"

Thus, a quite impossible situation comes to light, for it seems that
any true betterment of chiropractic will have to come from a change in chiropractic
itself. This, however, would do away with chiropractic, as many chiropractors
practice it, since the profession presently maintains its independence by
adherence to its original philosophy of the cause and cure of disease .
. . a philosophy that is still thoroughly rejected in medical circles. Louis
S. Reed, Ph.D., for example, author of The Healing Cults (1932),
stated: "The chiropractic theory of disease runs counter to so many
of the established facts of medical science that it is not entitled to serious
consideration." Today, these sentiments are still echoed by medical
authorities when chiropractic is presented as the "most important treatment
for disease." As long as chiropractic schools continue to teach a single
and "sovereign" method of treating human disease, they will, perhaps,
never measure up to the recommendations put down by a New Jersey Legislative
Committee in 1949:

The fullest possible understanding of the human body by a practitioner
is an absolute requirement. This means that he must not only know ... the
basic sciences, but also how to apply this knowledge in diagnosing the
ills of people. A practitioner, the committee believes, ought to be acquainted
with all the known means by which a bodily condition can be cured or alleviated,
so that lie may use his best judgment in choosing therapy [16].

Steadily increased educational requirements would probably trend the
better-educated chiropractor to a more scientific manner of thought and
practice, with the recipient of such training ultimately abandoning his
background of cultism. But what does this mean for chiropractic -- change
or extinction? So far, any worthwhile change in chiropractic methods has
come about by the simple addition of accepted medical procedures and courses
in a few schools with somewhat higher educational standards. Although it
seems that such changes would continue to be stimulated by standards that
will inevitably be required for all practitioners who treat human disease,
the efforts of many in the chiropractic profession are directed toward preventing
any change in chiropractic methods and standards. The late Dr. B.J Palmer,
for example, son of the founder of chiropractic and owner of the largest
chiropractic school in the world, stated in his 1959 book, Shall Chiropractic
Survive?:

It is MY heritage to protect, defend, and preserve my father's brilliant
world-wide discovery of the ONLY principle of the cause and cure of all
disease, locating THE KEY which restores health from Innate above-downward,
inside-out, which fills the vacuum made by medical failures. To see the
NCA drag him in the mud, washed down the sewer thru the machinations of
three or four men who don't care what happens TO ChiropracTIC or ChiropracTORS,
preaching, practicing, poaching on the legitimate territory of other professions.
You unsuspecting ChiropracTORS should refuse to be made SLAVES with those
detestable schemes [17].

Naturopathy and Chiropractic

As of 1958, only five states (Arizona, Connecticut, Oregon, Virginia,
and Utah) separately classified and provided licensing provisions for naturopaths.
A few states, however, did permit licensing of drugless healers following
examination by a medical board. The licensed practitioner was then restricted
to the practice of his designated field, whether it be chiropractic, naturopathy,
or mechanotherapy. (A good number of states have repealed their laws licensing
naturopaths within recent years.)

Chiropractic schools that employ the use of physiotherapy teach a course
that is very similar to the practice of naturopathy. Likewise, the three
or four naturopathic schools still operating today have a curriculum very
similar to that of many chiropractic colleges. In fact, at least four chiropractic
colleges awarded naturopathic degrees along with the chiropractic degree
before they came under the jurisdiction of the National Chiropractic Association,
which prohibited them from issuing naturopathic degrees. This practically
amounted to a death-dealing blow to the profession of naturopathy.

The Los Angeles College of Chiropractic, before it was approved by the
National Chiropractic Association, to take an example, granted naturopathic
degrees up until sometime in 1948. When the school discontinued the teaching
of naturopathy, no change was made in the curriculum except to discontinue
approximately 240 to 400 hours of training in herbology. The graduates of
the Los Angeles School, or any other chiropractic school, who wish to have
a naturopathic degree, can, however, attend a graduate naturopathic school,
take a course in "botanical medicine," and be awarded the N.D.
degree. A naturopathic school in Los Angeles, California, for example, requires
approximately 140 hours of training in addition to the training received
at a chiropractic school. This school, the Sierra States University, was
originally chartered to grant chiropractic, naturopathic, physical therapy,
and psychology degrees. According to a California Legislative Committee,
there is evidence that the school has issued at least two Ph.D. degrees;
one in 1947 and one in 1954 [18].

As recently as 1950, graduates of the National Chiropractic College,
a school approved by the National Chiropractic Association, were awarded
the degree of "Doctor of Naturopathy" along with the title of
Doctor of Chiropractic. The Western States Chiropractic College, also approved
by the National Chiropractic Association, awarded naturopathic degrees until
recent years. Although this school no longer offers this degree, 21 out
of 33 faculty members claimed degrees in naturopathy in its 1957-59 catalog.

While the National Chiropractic Association has included the use of physical
therapy and other measures in its definition of chiropractic practice, the
International Chiropractic Association, in refusing to approve the use of
other forms of therapy in conjunction with the chiropractic treatment, contends
that the National Association, in approving such "mixed" schools
as the Los Angeles College and the Western States College (in attempting
to widen the scope of the chiropractor's treatment methods), has headed
the chiropractic profession toward the equally "terrible" fate
of osteopathy (absorption by medicine) or naturopathy (extinction). Whatever
the final outcome of chiropractic might prove to be, it seems quite improbable,
in any event, that the chiropractor could continue to treat human disease
in competition with medical practice simply by manipulating the spinal column.
While chiropractic factions continue to argue among themselves as to what
is or is not chiropractic, some states have, in order to settle the question,
simply passed laws limiting the chiropractor to the fundamental practice
of chiropractic, making no provisions for the use of anything but the spinal
adjustment. Although some chiropractors have voluntarily placed such limitations
upon themselves in certain states, there are other states in which the majority
of chiropractors have agreed to include a wider variety of treatment measures
-- depending upon existing statutes.

Most of the chiropractic schools (those approved by the National Chiropractic
Association) are restricted to the issuance of chiropractic degrees, but
the naturopathic schools may award a degree in "drugless therapy"
by such title as that needed for licensure in a particular state. The school
in Ohio (the Central States College of Naturopathy), for example, may award
a degree of Doctor of Mechanotherapy for licensure in Ohio, or the degree
Doctor of Naturopathy for registration in other states. According to its
catalogue:

The several practices in the field of naturopathy are known by many
names, such as "movement cure," "nature cure," "osteopathy,"
"natural therapeutics," "mechanotherapy," "chiropractic,"
sanipractic," "drugless healing," and many other names.
Obviously, this multiplicity of names has resulted in considerable confusion
in the minds of the general public, and even more so in the minds of the
several states' legislative bodies. The result is that the practice of
naturopathy is styled by one or more of these names in laws regulating
its practice [19].

In comparing the course of study given in the chiropractic, naturopathic,
and medical schools, the impression is conveyed that all three schools teach
a similar course. The quality, however, is revealed in the faculty of instruction
and the facilities available for such instruction.

Although chiropractors contend that they are not practicing medicine,
naturopathy, a practice that also teaches "spinal diagnosis and treatment"
(most of the instructors in a naturopathic school have chiropractic degrees),
claims to be "the oldest system of medical practice in existence,"
and that it is part of the "four great branches of the 'medical tree,'
i.e. the allopathic, the homeopathic, the eclectic, and the naturopathic
branches." [19] Thus, according to the naturopath, chiropractic is
a practice "specializing in just one phase of naturopathy under a special
name" and, as such, is the practice of medicine. We recall that the
bulwark of the chiropractor's existence is based upon the contention that
chiropractic is not the practice of medicine and is therefore not subject
to the control of medical licensing bodies.